Comparative study of minimally invasive versus open esophagectomy for esophageal cancer in a single cancer center  

作　　者：Mu Juwei Yuan Zuyang Zhang Baihua Li Ning Lyu Fang Mao Yousheng Xue Qi Gao Shugeng Zhao Jun Wang Dali Li Zhishan Gao Yushun Zhang Liangze Huang Jinfeng Shao Kang Feng Feiyue Zhao Liang Li Jian Cheng Guiyu Sun Kelin He Jie 

机构地区：[1]Department of Thoracic Surgical Oncology, Cancer Institute & [2] Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China

出　　处：《Chinese Medical Journal》2014年第4期747-752,共6页中华医学杂志（英文版）

摘　　要：Background In order to minimize the injury reaction during the surgery and reduce the morbidity rate,hence reducing the mortality rate of esophagectomy,minimally invasive esophagectomy （MIE） was introduced.The aim of this study was to compare the postoperative outcomes in patients with esophageal squamous cell carcinoma undergoing minimally invasive or open esophagectomy （OE）.Methods The medical records of 176 consecutive patients,who underwent minimally invasive esophagectomy （MIE） between January 2009 and August 2013 in Cancer Institute ＆amp; Hospital,Chinese Academy of Medical Sciences,were retrospectively reviewed.In the same period,142 patients who underwent OE,either Ivor Lewis or McKeown approach,were selected randomly as controls.The clinical variables of paired groups were compared,including age,sex,Charlson score,tumor location,duration of surgery,number of harvested lymph nodes,morbidity rate,the rate of leak,pulmonary morbidity rate,mortality rate,and hospital length of stay （LOS）.Results The number of harvested lymph nodes was not significantly different between MIE group and OE group （median 20 vs.16,P=0.740）.However,patients who underwent MIE had longer operation time than the OE group （375 vs.300 minutes,P 〈0.001）.Overall morbidity,pulmonary morbidity,the rate of leak,in-hospital death,and hospital LOS were not significantly different between MIE and OE groups.Morbidities including anastomotic leak and pulmonary morbidity,inhospital death,hospital LOS,and hospital expenses were not significantly different between MIE and OE groups as well.Conclusions MIE and OE appear equivalent with regard to early oncological outcomes.There is a trend that hospital LOS and hospital expenses are reduced in the MIE group than the OE group.Background In order to minimize the injury reaction during the surgery and reduce the morbidity rate,hence reducing the mortality rate of esophagectomy,minimally invasive esophagectomy （MIE） was introduced.The aim of this study was to compare the postoperative outcomes in patients with esophageal squamous cell carcinoma undergoing minimally invasive or open esophagectomy （OE）.Methods The medical records of 176 consecutive patients,who underwent minimally invasive esophagectomy （MIE） between January 2009 and August 2013 in Cancer Institute ＆amp; Hospital,Chinese Academy of Medical Sciences,were retrospectively reviewed.In the same period,142 patients who underwent OE,either Ivor Lewis or McKeown approach,were selected randomly as controls.The clinical variables of paired groups were compared,including age,sex,Charlson score,tumor location,duration of surgery,number of harvested lymph nodes,morbidity rate,the rate of leak,pulmonary morbidity rate,mortality rate,and hospital length of stay （LOS）.Results The number of harvested lymph nodes was not significantly different between MIE group and OE group （median 20 vs.16,P=0.740）.However,patients who underwent MIE had longer operation time than the OE group （375 vs.300 minutes,P 〈0.001）.Overall morbidity,pulmonary morbidity,the rate of leak,in-hospital death,and hospital LOS were not significantly different between MIE and OE groups.Morbidities including anastomotic leak and pulmonary morbidity,inhospital death,hospital LOS,and hospital expenses were not significantly different between MIE and OE groups as well.Conclusions MIE and OE appear equivalent with regard to early oncological outcomes.There is a trend that hospital LOS and hospital expenses are reduced in the MIE group than the OE group.

关 键 词：surgical procedures minimally invasive ESOPHAGECTOMY comparative study 

分 类 号：S858.974[农业科学—临床兽医学] X503.1[农业科学—兽医学]